title: Efficiency of bone density testing by dual-biphotonic X-rays absorptiometry for diagnosis of osteoporosis according to French guideline recommendations: the PRESAGE study.
abstract: OBJECTIVE
  Bone mineral density is a major risk factor of fracture. Its measurement is reimbursed by French national health insurance according to clinical criteria. In this multicentre cross-sectional observational study, we estimated the proportion of postmenopausal women with osteoporosis among those referred for a bone mineral density measurement. Risk factors for osteoporosis and therapeutic recommendations were described.
  
  
  RESULTS
  Six hundred and forty-six postmenopausal women were evaluated. Osteoporosis was diagnosed in 57.6%, osteopenia in 38.7% and a normal bone mineral density in 3.7%. The main risk factors for fracture were personal history of fracture (40%), family fracture (23%), smoking (15%) and glucocorticoids use (15%). Anti-osteoporosis drug was recommended for 93% of women with osteoporosis and for 45% of women with osteopenia. A logistic regression analysis showed that a T-score=-2.5 was the most important factor related to the treatment decision-making. Cluster analysis identified five types of women with different combinations of fracture risk factors. The percentage of postmenopausal women -96.3% - referred for bone mineral density and for whom a treatment could be recommended had osteoporosis or osteopenia.
  
  
  CONCLUSIONS
  In spite of recommendations, the physician therapeutic decision-making was mainly based on the bone mineral density result.
authors.affiliation: Service de rhumatologie, CHU de Rennes, 16, boulevard de Bulgarie, 35200 Rennes, France. pascal.guggenbuhl@chu-rennes.fr
authors.forename: Pascal
authors.initials: P
authors.lastname: Guggenbuhl
authors.forename: Rémi
authors.initials: R
authors.lastname: Dufour
authors.forename: Soyi
authors.initials: S
authors.lastname: Liu-Léage
authors.forename: Hélène
authors.initials: H
authors.lastname: Sapin
authors.forename: Bernard
authors.initials: B
authors.lastname: Cortet
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods* / Q000592:standards*; D000368:Aged; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000453:epidemiology; D016000:Cluster Analysis; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D005938:Glucocorticoids / Q000627:therapeutic use; D019983:Guideline Adherence; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D015663:Osteoporosis, Postmenopausal / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D017410:Practice Guidelines as Topic; D015995:Prevalence; D012307:Risk Factors
chemical_list: D005938:Glucocorticoids